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Pelvic fracture bleeding control: What you need to know
Todd W Costantini1, Clay Cothren Burlew, Whitney R Jenson
1From the Division of Critical Care and Acute Care Surgery, Department of Surgery (T.W.C.), University of Minnesota Medical School, Minneapolis; Division of Acute Care Surgery (T.W.C.), North Memorial Health, Robbinsdale, Minnesota; Division of Gastrointestinal, Trauma, and Endocrine Surgery, Department of Surgery (C.C.B., W.R.J.), University of Colorado, Aurora, Colorado; Department of Trauma Surgery (R.P.), University Hospital Zurich; Harald-Tscherne Laboratory for Orthopaedic and Trauma Research (F.K.-L.K.), University Hospital Zurich, University of Zurich, Zurich, Switzerland; Division of Vascular and Endovascular Trauma (R.K.), R Adams Cowley Shock Trauma Center, University of Maryland Medical Center; Department of Surgery (T.M.S.), R Adams Cowley Shock Trauma Center, University of Maryland Medical System, Baltimore, Maryland; and Riverside University Health System (R.C.), Loma Linda University School of Medicine, Riverside, California.
Hemorrhage from pelvic fractures is life-threatening. Prompt management includes resuscitation, pelvic binders, and hemorrhage control via methods like angioembolization or surgery, tailored to patient status and resources.
Area of Science:
- Trauma surgery
- Emergency medicine
- Hemorrhagic shock management
Background:
- Pelvic fractures frequently cause severe bleeding, leading to high mortality rates.
- Prompt intervention is critical for improving patient outcomes in cases of pelvic fracture hemorrhage.
Purpose of the Study:
- To outline essential knowledge for optimal care of patients with severe pelvic fracture hemorrhage.
- To discuss initial evaluation and hemorrhage control strategies for pelvic fractures.
Main Methods:
- Review of current literature and clinical practices for managing pelvic fracture hemorrhage.
- Discussion of various hemorrhage control options, including external fixators, angioembolization, pelvic packing, and surgical ligation/embolization.
Main Results:
- Initial management focuses on hemostatic resuscitation, pelvic binder application, and exclusion of other bleeding sources.
- Hemorrhage control interventions must be individualized based on patient physiology and available resources.
Conclusions:
- Effective management of pelvic fracture hemorrhage requires a tailored approach combining resuscitation and specific bleeding control techniques.
- Optimal care necessitates prompt evaluation and selection of appropriate interventions based on patient condition and resource availability.
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